Selective mutism and its effective treatment

In most cases children suffering from selective mutism shows symptoms in school, whereof most intervention occurs from the age six to eight years old. Nevertheless the symptoms can start showing already at the age of three years old. Many children do not get diagnosed as a result of parents believing their child is only shy or that that this is just temporarily and the child will grow out of it soon. This is understandable as associated features to selective mutism is shyness, social isolation, negativism, fear and difficulties to control their temper and behaviors. However it is important to diagnose as this disorder can last from some mounts or years (Krysanski, 2001).

Selective mutism is a psychiatric disorder of childhood which is characterized with the total lack of speech in specific social situations, despite being able to speak in other situations. In order to diagnose selective mutism the failure to speak need to have been occurring for more than 1 month, and can not be a result of language barriers or being in the first month of school. Additionally, the lack of speaking interferences with  educational achievement or social communication. (Kearney, 2005)

The etiology of selective mutism has varied a lot, including many different theories. For instance some behaviorists believe that it is due to a long period of behaviors being  negatively reinforced. They believe that the mutism exits as a interaction between the environment and the child, viewing the silent as a function  (Krysanski, 2001). Other authors believe that the mutism is a result of social phobia, as social anxiety was present in many of the children with selective mutism. In addition many children diagnosed also had social phobia present in their family origin. Further on is the explanation of the mutism as a reaction to trauma, such as parents being divorced, abuse, losing someone or a specific experience  (Krysanski, 2001).

The first treatment to mention is psychodynamic treatment, focusing on the  underlying intrapsychic conflict, often presented with play therapy. As the treatment is time consuming and their behavior therapy exist little research on the field, it is hard to say if the success is a result of time or the treatment. Moreover the more successful treatment on selective mutism is behavior therapy techniques including reinforce, shaping, self-modeling, contingency management and stimulus fading  (Krysanski, 2001).. Last  therapy to mention is family therapy, to work with dysfunctional patters in the family and bring it to the conscious awareness. It includes making the family aware of their behavior as a reinforcer for the kid. 

                                           References:

Kearney, J. L. (2005). Selective Mutism in Children: Comparison to Youths With and Without Anxiety Disorders.SpringerLink:  https://link.springer.com/article/10.1007/s10862-005-3263-1

Krysanski, V. L. (2001). A Brief Review of Selective Mutism Literature. Taylor and Francis Online: https://www.tandfonline.com/doi/abs/10.1080/00223980309600597